目的探讨下唇或加颊黏膜与生殖器带蒂皮瓣联合修复复杂性长段前尿道狭窄的疗效。方法 2010年8月至2013年8月我科收治因外伤、慢性炎症、尿道下裂术后引起的复杂性男性前尿道长段狭窄患者8例。狭窄段长度6.5~12cm,平均8.5cm,均为严重狭窄或闭锁。术中将狭窄段尿道完全切除,根据尿道缺损长短切取相应长度下唇黏膜,若下唇黏膜取材不足时加取颊黏膜,将游离黏膜固定于阴茎海绵体腹侧表面,取阴茎或联合阴囊腹侧纵行皮瓣,皮瓣侧方覆盖并与下唇或加颊黏膜缝合形成新尿道。结果术后随访6~30个月,平均20个月。7例患者排尿通畅,最大尿流率(Q_(max))18.2~34.5 ml/s,平均20.8 ml/s。1例术后1个月出现尿道外口狭窄,反复尿道扩张效果不理想,Q_(max)8.5 ml/s,术后3个月行尿道外口切开后排尿通畅,Q_(max)25.5ml/s。结论对于超长段、尿道严重狭窄甚至闭锁、尿道海绵体病变严重、阴茎皮肤缺损等复杂性尿道狭窄患者,采用下唇或加颊黏膜与生殖器带蒂皮瓣联合修复效果较好。 Objective To investigate the curative effect of lower lip or buccal mucosa combined with pediatric genital pedicle flap in the repair of complex long anterior urethral stricture. Methods From August 2010 to August 2013, 8 patients with complicated long-term anterior urethral stenosis caused by trauma, chronic inflammation and hypospadias were treated in our department. The length of the narrow segment 6.5 ~ 12cm, an average of 8.5cm, are severe stenosis or atresia. According to the length of the urethra defect, the lower lip mucosa was cut according to the length of the urethra defect. If the lower lip mucosa was lacking enough, the buccal mucosa was taken out, the free mucosa was fixed on the ventral surface of the penis corpus, the penis or the joint scrotum was taken Side longitudinal flaps, flaps flanking the cover and the lower lip or buccal mucosa suture to form a new urethra. Results Postoperative follow-up 6 to 30 months, an average of 20 months. Urinary patency was observed in 7 patients. The maximum flow rate (Q max) was 18.2 to 34.5 ml / s with an average of 20.8 ml / s. One case had urethral stenosis at one month after operation, and the urethral dilatation was not satisfactory. The Q max was 8.5 ml / s. After three months, urethral patency was achieved after the urethral incision. Q max 25.5 ml / s. Conclusions For patients with complicated urethral stenosis, such as long segment, severe stricture of the urethra or even occlusion, severe urethral cavernous lesions and penile skin defect, the lower lip or buccal mucosa and genital pedicle flap are better.